Hepatitis B virus in oocytes and embryos: pregnancy outcomes and children's health

卵母细胞和胚胎中的乙型肝炎病毒:妊娠结局和儿童健康

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Abstract

OBJECTIVE: To investigate whether the presence of hepatitis B virus (HBV) in oocytes and embryos affects pregnancy outcomes for in vitro fertilization and embryo transfer (ET) as well as is related to the vertical transmission of HBV to children. DESIGN: Retrospective cohort study. SETTING: A university-affiliated fertility center. PATIENTS: This study included 167 couples with at least 1 hepatitis B surface antigen-seropositive partner. These couples underwent in vitro fertilization-ET, and the discarded oocytes and embryos had been tested for HBV. Couples with HBV-positive oocytes or embryos were categorized as the positive group, whereas those couples with HBV-negative oocytes and embryos served as the negative group. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Pregnancy outcomes and the rate of children's HBV infection. RESULTS: The pregnancy outcomes of fresh and frozen ETs were not associated with the presence of HBV in the oocytes and embryos. Of the 106 infants born, 1 child whose mother tested positive for hepatitis B surface antigen but had negative oocytes and embryos was infected with HBV. Additionally, 26.09% of children who had been administered passive immunization and active vaccinations did not reach protective levels of anti-HBV antibodies (hepatitis B surface antibodies) and became nonresponders. The negative rate of children's hepatitis B surface antibody was associated with the presence of HBV in oocytes and embryos (odds ratio, 3.01; 95% confidence interval, 1.04-9.25). CONCLUSIONS: The presence of HBV in oocytes and embryos did not affect pregnancy outcomes or result in the vertical transmission of HBV to the offspring of HBV carriers. Follow-up is needed for HBV-vaccinated children with an HBV-infected parent. Booster vaccinations are necessary for continued protection.

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